The way we were: Health care reform

I can hear in my mind’s ear Barbra Streisand’s beautifully haunting song "The Way We Were." It was a nostalgic, wistful song in a movie of the same name.

I can hear in my mind’s ear Barbra Streisand’s beautifully haunting song "The Way We Were." It was a nostalgic, wistful song in a movie of the same name.

But sometimes, like now, it reminds me of how far we’ve come.

I can also see, almost as clearly as a personal memory, Matt Damon in his role as Rudy Baylor in "The Rainmaker." (Warning: Spoilers ahead!) Rudy, the working class son of an abusive alcoholic, has freed himself and become a lawyer, and is just starting his career as the movie begins. The only case he can get is that of insurance bad faith.

Dotty and Buddy Black come to Damon to seek justice from Great Benefit, an insurance company that refuses to pay for a covered bone marrow transplant for their son, Donny Ray. It’s too late now, Donny is dying; but he wants justice and he wants to leave his parents the money he’s entitled to.

Donny dies, but not before giving a video deposition. In the end, after many devious moves by big firm lawyers, Rudy wins the case. But the insurance company declares bankruptcy, giving Donny Ray’s parents only the satisfaction of a ruling of wrongdoing by "Great Benefit." The heartbreaking case causes Rudy to decide to quit practicing law and to teach legal ethics instead.

The history of health care, and health insurance, is complicated. As the economy has changed, technology has advanced and national responsibilities have become more complex, we’ve moved through various models of how to pay for health care. We now have a hodgepodge of fee-for-service, pre-paid, employer benefit and good-luck-you’re-on-your-own. And God knows, I have been through all of the above.

And for decades, the health insurance industry, intent on maximizing profits for shareholders, has often desecrated the mission of insurance: Instead of providing medical care at a time of need, insurance companies have denied claims and refused coverage.

A hundred years ago, Theodore Roosevelt proposed the first national health care system: "We pledge ourselves to work unceasingly in State and Nation for … the protection of home life against the hazards of sickness … through the adoption of a system of social insurance adapted to American use."

Health care reform and the expansion of existing coverage has been on the agenda of every American president since FDR. What Harry Truman, Richard Nixon, John F. Kennedy, Lyndon Johnson and Bill Clinton could not achieve — a national system of health insurance — Barack Obama did.

And Obama’s expansion of Medicare and Medicaid builds on legislation supported by Presidents George W. Bush and Ronald Reagan.

Experts consider the Affordable Care Act, ironically based on a model Mitt Romney introduced to Massachusetts, to be moderate and rather American in approach. More importantly, as Alan S. Binder writes in The Wall Street Journal: "The three central elements of ObamaCare are insurance reform, getting (most of) the uninsured covered, and containing the upward spiral in medical-care costs. Each remains in place." This despite the botched rollout.

We all have horror stories about friends or family members betrayed by their health insurers, or denied coverage, or charged escalating, bankruptcy-inducing premiums, resulting in diseases undiagnosed, illnesses allowed to debilitate, treatable conditions left untreated. And worse — death.

That is the way we were.

A few years ago, Cokie Roberts said on ABC’s "This Week": "We already have national health insurance. It’s called the emergency room, and it’s the most expensive kind we can have." Why? Because, as Business Insider’s Henry Blodget wrote, "wildly profitable hospitals" fold the ER bills of the uninsured into everyone else’s. And taxpayers often help foot the bill.

Obama made a rhetorical slip when he said, "if you like your policy, you can keep it." Though true for about 97.5 percent of the insured population, Obama probably should have added a Jon Stewart-like qualification: You can keep your health plan, unless it no longer meets the minimum requirements, or your insurance company stops offering it — because it was bad to begin with.

But Republican leaders are not looking to fix any flaws in the ACA — they want to dismantle it. Rep. Fred Upton, R-Mich., has introduced a "fix" to canceled insurance policies — with the newspeak name "Keep Your Plan." It’s a gift to the insurance industry, exempting millions from the protections of Obamacare. One person compared it to offering to fix a leaky roof by stripping it off completely.

The media, and Republicans, distorted (as usual) the import of former President Clinton’s comment that the government should keep its pledge. First, he wasn’t urging a reluctant Obama to act. He was agreeing with Obama, who had already said he would do that.

Second, the comment was just 31 words out of a 335 statement that emphasized, "The big lesson is we’re better off with this program than we are without it."

During October, the first month, 106,185 Americans enrolled in the health insurance marketplaces (not counting those added to Medicaid). While that’s lower than hoped for, it’s 863 times more than Romney’s plan enrolled in the same time period: a total of 123.

Further, 26 million people have made individual shopping tours of the Obamacare website. As with "Romneycare," the majority are expected to enroll later, rather than early.

President Obama understands why people are frustrated. And now he must take the lead to fix it. And yes, keep his promise and work harder to ensure his policies work to help Americans grow, prosper and stay healthy in the process.

Donna Brazile is a political commentator on CNN, ABC and NPR, and a contributing columnist to Roll Call, the newspaper of Capitol Hill.